During all laparoscopic surgeries, a surgeon inserts a Veress needle into a peritoneum of a subject, such as a human patient; and, inflates the peritoneum with carbon dioxide (CO2) to create room to operate. In a current approach, the Veress needle is blindly passed through an abdominal wall of a subject to provide a port of entry for CO2 insufflation. There is only gross resistive feedback for Veress needle insertion.
This blind insertion can lead to problems, such as premature insufflation or puncturing of an organ inside the peritoneal sac. Furthermore, blind insertion leads to a high rate of first pass failure and results in some incidences of morbidity. For example, unsuccessful insertion of Veress needles, possibly leading to puncture of blood vessels or organs in the abdomen, can lead to significant injury. If not recognized during the operation (intra operatively) and repaired immediately, excessively penetrating Veress needles induce increased morbidity and mortality. At the other extreme, the needle may not be inserted far enough, and remain in tissue fascia, leading to embolism and potential tissue damage during insufflation. A 15% first pass failure rate, 0.3% morbidity rate, and 0.07% mortality rate are associated with use of the Veress needle, principally from either failing to fully penetrate into the peritoneum or puncturing vital organs and vessels.
Pressure sensor equipped Veress needles exist, but due to the variability of intraperitoneal and fascial pressure and differences between patients, they have not been widely accepted. Other existing approaches, such as a Lapcap, require a surgeon to retrain for a dramatically altered procedure called for by the device, or introduce significant drawbacks, such as needle slippage or additional tissue trauma, or some combination.